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This study investigated the effect of Ramadan fasting on body composition, caloric intake, and training load in 10 female rugby players. Assessments were conducted during three periods: one week before Ramadan, the first week of Ramadan and the last week of Ramadan. Results revealed that during Ramadan, compared to the week before Ramadan, there was a decrease in training load (ηp2 = 0.90), waist circumference (ηp2 = 0.84), body mass (ηp2 = 0.68), fat mass (ηp2 = 0.73), and body fat index (ηp2 = 0.70). Conversely, participants consumed more lipids during Ramadan than a week before it (ηp2 = 0.67). Moreover, higher training load was related to lower body mass index (rs = -0.69) and higher protein intake (rs = 0.62). Ramadan fasting in female rugby players may induce specific changes in body composition, caloric intake, and training load. [ABSTRACT FROM AUTHOR]

Background: Critically ill patients with obesity (PwO) have anthropometric characteristics that can be associated with different nutritional-metabolic requirements than other critically ill patients. However, recommendations regarding nutrition delivery in PwO are not clearly established among the different published clinical practice guidelines (CPGs). Our main aim was to evaluate the impact of energy and protein intake in critically ill PwO. Methods: A multicenter (n = 37) prospective observational study was performed. Adult patients requiring medical nutrition therapy (MNT) were included, and PwO (BMI ≥ 30 Kg·m−2) were analyzed. Demographic data, comorbidities, nutritional status, and the average caloric and protein delivery administered in the first 14 days, including complications and outcomes, were recorded in a database. Patients were classified and analyzed based on the adequacy of energy and protein intake according to CPG recommendations. Results: 525 patients were included, of whom 150 (28.6%) had obesity. The energy delivery was considered inadequate (<11 Kcal/Kg/d) in 30.7% (n = 46) and adequate (≥11 Kcal/Kg/d) in 69.3% (n = 104) of cases. PwO who received adequate energy delivery had greater use of the parenteral route and longer mean hospital stays (28.6 ± 26.1 vs. 39.3 ± 28.1; p = 0.01) but lower ICU mortality (32.6% vs. 16.5%; p = 0.02). Protein delivery was inadequate (<0.8 g/Kg/d) in 63.3% (n = 95), insufficient (0.8–1.2 g/Kg/d) in 31.33% (n = 47), and adequate (≥1.2 g/Kg/d) in only 5.4% (n = 8) of patients. PwO with inadequate protein delivery—compared with insufficient delivery—had higher use of the parenteral route and lower mortality in the ICU (25.5% vs. 14.9%; p = 0.02). Multivariate analysis revealed that PwO who received adequate energy delivery (hazard ratio [HR]: 0.398; 95% confidence interval [CI]: 0.180–0.882; p = 0.023) had better survival, while patients with insufficient protein delivery (HR: 0.404; CI 95%: 0.171–0.955; p = 0.038) had better survival than those with inadequate delivery. Conclusion: PwO can frequently receive inadequate energy and protein delivery from MNT during an ICU stay, which may impact the short-term mortality of these critically ill patients. It is emerging to develop strategies to optimize MNT delivery in these patients, which may improve their outcomes. NCT Registry: 03634943. [ABSTRACT FROM AUTHOR]

Background/Objectives: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by profound nutritional deficits and significant alterations in body composition, cellular integrity, and hydration. Nutritional rehabilitation is critical not only for weight restoration but also for improving body composition and metabolic functions. However, optimal strategies for integrating caloric and protein intake to achieve balanced recovery remain underexplored. This study aims to evaluate the interactions between caloric/protein intake and time on quantitative (weight and BMI) and qualitative (body composition and cellular health) outcomes, and to identify markers that predict recovery trajectories and guide personalized nutritional interventions. Methods: This retrospective observational study analyzed 79 patients with AN admitted to Villa Miralago for six months of nutritional rehabilitation. Anthropometric and body composition parameters—including body weight (BW), body mass index (BMI), fat mass (FM), fat-free mass (FFM), body cell mass (BCM), phase angle (PA), and hydration markers (TBW and ECW)—were assessed at baseline (T0), 3 months (T1), and 6 months (T2). Generalized Estimating Equations (GEEs) were used to evaluate the effects of caloric and protein intake over time. Results: Significant increases in BW (+6.54 kg, p < 0.0001) and BMI (+2.47 kg/m2, p < 0.0001) were observed, alongside improvements in FM, FFM, and BCM. PA increased significantly (+0.47°, p < 0.0001), indicating enhanced cellular health. TBW increased (+1.58 L, p < 0.0001), while ECW% decreased, reflecting improved fluid distribution. Caloric intake predominantly influenced early fat mass recovery, while protein intake was crucial for preserving lean tissues and promoting cellular regeneration. Interaction effects between caloric/protein intake and time revealed dynamic changes in body composition, underscoring the need for adaptive strategies. Conclusions: This study highlights the importance of a dynamic, marker-based approach to nutritional rehabilitation in AN. Integrating caloric and protein intake with advanced body composition and hydration markers enables personalized interventions and balanced recovery, shifting AN treatment toward a focus on qualitative improvements overweight restoration alone. [ABSTRACT FROM AUTHOR]

Objectives: Skeletal muscle wasting is a common occurrence in critical illness, often resulting in intensive care unit (ICU)‐acquired weakness. This study aims to identify clinical factors associated with muscle decay in mechanically ventilated critically ill children. Utilizing point‐of‐care ultrasound, a noninvasive and cost‐effective tool, we assess muscle decay through ultrasound of the quadriceps femoris. Methods: A prospective observational study was conducted in a single‐center quaternary‐care pediatric intensive care unit at a children's hospital. A convenience sample of 103 sedated and mechanically ventilated patients were enrolled in this study. Ultrasound measurements of quadriceps femoris muscle thickness were taken, and daily muscle decay rates were calculated. Demographic, clinical, and outcome data were analyzed for correlations with muscle decay. Results: Among the enrolled patients, 67 had repeat measurements. Muscle thickness change aligned with prior studies, with a mean daily change of −1.9% [IQR −0.8, −5.0]. Adequate cumulative caloric intake (>60% of goal) correlated with less muscle decay compared with inadequate intake (−1.8 vs −2.4%, P <.001). Average daily muscle change correlated with both ICU and hospital length of stay (LOS) (r =.328, P =.007 and r =.393, P =.001). No significant correlations emerged between muscle change and mortality, disease severity, fluid balance, early mobilization, steroid exposure, or sedative and paralytic use. Conclusion: This study demonstrates early and frequent muscle decay in critically ill children, as detected by point‐of‐care ultrasound. Average daily muscle decay was associated with longer ICU and hospital LOS. Adequate cumulative caloric intake is linked to reduced muscle decay. These findings contribute to understanding muscle wasting in critically ill pediatric patients. Access the CME test here and search by article title. [ABSTRACT FROM AUTHOR]

Background & Objective: Type-2 Diabetes Mellitus (T2DM) is one of the most common chronic non-communicable diseases and a serious health issue worldwide because of its rising prevalence amongst the young adults. Dietary diversity, rapid economic development and sedentary lifestyle are amongst the common factors contributing for the rapid rise of diabetes. Our objective was to assess the average carbohydrate (CHO) and caloric consumption and its association with obesity and disease status in patients with Type-2 diabetic patients in an outpatient setting. Methods: This study was performed at an outpatient department (OPD), of Hayatabad Medical Complex, Peshawar. Patients with T2DM were interviewed who completed dietary assessment using 24 hours dietary recall method. Results: A total of 150 patients with Type-2 diabetes were interviewed. The mean carbohydrate intake was 400.3±106 mg/day, out of which 43.3 % participant’s had carbohydrate intake above recommendations. The mean energy intake for all participants was 2504.5±587.4 Kcal/day. Majority of the participants were overweight and obese with mean BMI of 28kg/m² ± 4.4. There was no significant difference in energy and carbohydrate intake between male and female participants. Conclusions: Majority of Pakistani patients with Type-2 diabetes consume foods rich in carbohydrate as well as have high caloric value. These finding were more in patients with no formal education compared to those who were well educated with a degree. [ABSTRACT FROM AUTHOR]

The prevalence of obesity has become a global health concern, with significant impacts on quality of life and mortality rates. Recent research has highlighted the role of ultra-processed foods (UPFs) in driving the obesity epidemic. UPFs undergo extensive processing, often containing high levels of sugars, fats, and additives, while lacking essential nutrients. Studies have linked UPF consumption to obesity and cardiometabolic diseases, underscoring the importance of dietary patterns rich in whole foods. Thus, the aim of this narrative review is to elucidate the correlation between ultra-processed foods and the increased trend of obesity and its related complications. These foods, prevalent in modern diets, contribute to nutritional deficiencies and excessive caloric intake, exacerbating obesity rates. Lifestyle factors such as busy schedules and quick meal management further drive UPF consumption, disrupting hunger regulation and promoting overeating. UPF consumption correlates with adverse health outcomes, including dyslipidemia, hypertension, and insulin resistance. Promoting whole, minimally processed foods and implementing school-based nutrition education programs are crucial steps. Also, numerous challenges exist, including unequal access to healthy foods, the industry's influence, and behavioral barriers to dietary change. Future research should explore innovative approaches, such as nutrigenomics and digital health technologies, to personalize interventions and evaluate policy effectiveness. Collaboration across disciplines and sectors will be vital to develop comprehensive solutions and improve public health outcomes globally. [ABSTRACT FROM AUTHOR]

Background/Aim: Physical decline is accompanied with malnutrition in advanced cancer patients, thus nutritional care is often provided with cancer rehabilitation. However, a limited number of studies have focused on which nutritional index serves as an important marker to provide more intensive nutritional support for patients. Patients and Methods: We retrospectively reviewed advanced cancer patients who received chemotherapy and rehabilitation during hospitalization. In analysis 1, patients were divided into two groups: a Well group with caloric intake ≥ basal metabolism, calculated by the Harris–Benedict equation, and a Poor group with caloric intake less than their basal energy expenditure. The primary endpoint was the ratio of patients whose Eastern Cooperative Oncology Group Performance Status (ECOG PS) or Barthel index (BI) was maintained during rehabilitation. In analysis 2, the cohort was restratified into Responders, whose ECOG PS and BI improved, and Non-responders, comprising the remaining patients. Several nutritional indices were compared between the groups. Results: Eighty-four patients were evaluated in analysis 1, namely 51 Well patients and 33 Poor patients. The ECOG PS-maintained rate was 98% and 91% (p=0.29), and the BI-maintained rate was 100% and 88% (p=0.02) in the Well and Poor groups, respectively. In analysis 2, 72 patients were evaluated after excluding 12 patients who lacked nutritional data after rehabilitation. Compared with the Responders group, caloric intake appeared worse in the Non-responders group, although their nutritional background tended to be better. Conclusion: Insufficient caloric intake might be a predictive marker of poor outcomes after rehabilitation in advanced cancer patients. [ABSTRACT FROM AUTHOR]

IntroductionProviding adequate nutrition to preterm infants to achieve postnatal growth similar to intrauterine growth remains challenging due to the unpredictability of individual determinants.Material and methodsWe used a calculation program for infant incubators to compare the estimated heat balance with the caloric intake and growth rate in Very Low Birth Weight Infants (VLBWI).Results and discussionA group of 32 VLBWI was studied over a period of 14–28 days. An interrelationship between thermal equilibrium and growth rate was observed, with standardized incubator settings being unable to avoid periods of negative thermal balance and concomitantly poor growth rate.ConclusionDetermining personalized incubator settings by means of a calculation program could help improve nutrition and growth in preterm infants.

Background: Adolescent is the second growth spurt and transitional phase in individual's life. Malnutrition is prevailing highly in adolescents. This study aims at studying the actual nutritional intake and the consumption pattern and its comparison with the newly formulated RDA 2024 among the school going Adolescents of the Lucknow City. Methods: 607 students of age 13–19 years from various government schools of Lucknow city were selected as early and late adolescents. Daily consumption of various macronutrients and micronutrients was obtained and compared with Recommended Dietary Allowance (RDA) 2024. Data was analysed using IBM SPSS software version 20. Results: The revised Dietary Guidelines-ICMR India (2024) talks about Estimated Energy Requirement (EER) rather than Recommended Dietary Allowance (RDA), the caloric intake as compared to Estimated Average Requirement (EAR) was found to be at lower side. Protein consumption was lower than Recommended Dietary Allowance (RDA). Whereas fat consumption was high. The study concluded that consumption of micronutrients in Early and Late adolescents was below Recommended Dietary Allowance (RDA). Conclusion: This results to conclusion that population had lower amount of nutrients intake as compared to the guidelines. Therefore, robust nutritional intervention approach is needed to address malnutrition prevailing in this area.

Introduction and Purpose: Understanding the crucial role of nutrition and sport in the postoperative recovery of cardiac surgery patients is paramount. Optimal nutrition aids in healing mitigates complications and enhances overall outcomes. This abstract focuses on the necessity of customized nutrition plans tailored to meet the unique recovery needs of post-cardiac procedures, emphasizing the importance of heart-healthy dietary choices for long-term cardiovascular health. Materials and methods: The literature available in PubMed, Scopus, and Google Scholar databases was reviewed using the following keywords: "nutrition"; “surgery nutrition; and "cardiac surgery nutrition" State of Knowledge: Evidence underscores the significance of a diet rich in omega-3 fatty acids, antioxidants, and soluble fiber in facilitating post-surgery recovery and promoting heart health. Strategies to reduce sodium and limit unhealthy fats are vital, as is incorporating whole grains, lean proteins, and various fruits and vegetables. Collaborative development of personalized dietary plans with healthcare professionals is critical for enhancing recovery and ensuring long-term health benefits. Conclusion: The integration of targeted nutritional strategies into postoperative care is essential for optimizing patient recovery and improving quality of life following cardiac surgery. Nutrition plays a foundational role in supporting the healing process, reducing the risk of complications and securing cardiovascular health in the long term.

Erythritol, a sugar alcohol derived from carbohydrate hydrolysis, is gaining attention for its unique properties and potential health benefits. While it occurs naturally in small quantities in certain foods, industrial production methods have made it a popular sugar substitute in various consumer products. Erythritol's sweetness coupled with its low or negligible calorie content, positions it as an attractive option for individuals seeking to manage weight or diabetes. Unlike some polyol sweeteners, erythritol's absorption in the small intestine does not lead to gastrointestinal distress, making it widely used in foods and beverages. Research indicates that erythritol's ingestion does not significantly impact serum glucose or insulin levels, making it suitable for individuals with diabetes or those managing carbohydrate intake. Moreover, erythritol shows promise in improving endothelial function and protecting against vascular complications associated with diabetes. Individuals with carbohydrate disorders or those who are overweight represent only a segment of the population that may benefit from erythritol. This sweetener also offers a spectrum of advantageous effects on oral and gastrointestinal health. However, while erythritol offers numerous potential benefits, further studies are needed to fully understand its long-term effects on the human body. This review compiles current data on erythritol's metabolism and underscores erythritol's multifaceted and beneficial potential role in health.

Several meta-analyses have found a positive association between a popular type of "fad diet", ketogenic diets, and their effect on anthropometric and blood parameters. However, the non-specific inclusion criteria for meta-analyses may lead to incorrect conclusions. The aim of this literature review is to highlight the main confounders and methodological pitfalls of meta-analyses on ketogenic diets by inspecting the presence of key inclusion criteria. The PubMed, Embase, and Web of Science databases and the Cochrane Database of Systematic Reviews were searched for meta-analyses. Most meta-analyses did not define the essential parameters of a ketogenic diet (i.e., calories, macronutrient ratio, types of fatty acids, ketone bodies, etc.) as inclusion criteria. Of the 28 included meta-analyses, few addressed collecting real, re-measured nutritional data from the ketogenic diet and control groups in parallel with the pre-designed nutritional data. Most meta-analyses reported positive results in favor of ketogenic diets, which can result in erroneous conclusions considering the numerous methodological pitfalls and confounders. Well-designed clinical trials with comparable results and their meta-analyses are needed. Until then, medical professionals should not recommend ketogenic diets as a form of weight loss when other well-known dietary options have been shown to be healthy and effective. [ABSTRACT FROM AUTHOR]

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The prevalence of obesity has become a global health concern, with significant impacts on quality of life and mortality rates. Recent research has highlighted the role of ultra-processed foods (UPFs) in driving the obesity epidemic. UPFs undergo extensive processing, often containing high levels of sugars, fats, and additives, while lacking essential nutrients. Studies have linked UPF consumption to obesity and cardiometabolic diseases, underscoring the importance of dietary patterns rich in whole foods. Thus, the aim of this narrative review is to elucidate the correlation between ultra-processed foods and the increased trend of obesity and its related complications. These foods, prevalent in modern diets, contribute to nutritional deficiencies and excessive caloric intake, exacerbating obesity rates. Lifestyle factors such as busy schedules and quick meal management further drive UPF consumption, disrupting hunger regulation and promoting overeating. UPF consumption correlates with adverse health outcomes, including dyslipidemia, hypertension, and insulin resistance. Promoting whole, minimally processed foods and implementing school-based nutrition education programs are crucial steps. Also, numerous challenges exist, including unequal access to healthy foods, the industry’s influence, and behavioral barriers to dietary change. Future research should explore innovative approaches, such as nutrigenomics and digital health technologies, to personalize interventions and evaluate policy effectiveness. Collaboration across disciplines and sectors will be vital to develop comprehensive solutions and improve public health outcomes globally.

Prader–Willi Syndrome (PWS) is the most frequent cause of genetic obesity. Early reports indicate that children with PWS require 20–40% fewer calories than healthy children to maintain adequate growth. Growth hormone treatment for children with PWS, approved in 2000, affects the body composition and probably affects energy requirements. This retrospective cross-sectional study analyzed the caloric intake in children with PWS aged from 6 months to 12 years old who underwent growth hormone treatment, comparing the patients' caloric intake calculated from parent-recorded dietary intake versus the recommended caloric intake for healthy children, taking into account the age, sex, height, weight, and physical activity. We analyzed the data from 25 patients (13 (52%) boys; mean age, 6.72 ± 2.81 y; median age at starting growth hormone treatment, 1.4 y (IQR: 0.78–2.29); 17 (68%) normal weight and 8 (32%) overweight or obese). The mean daily energy intake was 1208 ± 186 kcal/d, representing 96.83% ± 18.66 of the recommended caloric intake for healthy children. The caloric intake in children with PWS treated with growth hormone was very similar to that recommended for healthy children; thus, we should rethink the dietary recommendations for these children. [ABSTRACT FROM AUTHOR]

Long-chain fatty acids induce apolipoprotein A4 (APOA4) production in the small intestine and activate brown adipose tissue (BAT) thermogenesis. The increase in BAT thermogenesis enhances triglyceride clearance and insulin sensitivity. Acute administration of recombinant APOA4 protein elevates BAT thermogenesis in chow-fed mice. However, the physiological role of continuous infusion of recombinant APOA4 protein in regulating sympathetic activity, thermogenesis, and lipid and glucose metabolism in low-fat-diet (LFD)-fed mice remained elusive. The hypothesis of this study was that continuous infusion of mouse APOA4 protein would increase sympathetic activity and thermogenesis in BAT and subcutaneous inguinal white adipose tissue (IWAT), attenuate plasma lipid levels, and improve glucose tolerance. To test this hypothesis, sympathetic activity, BAT temperature, energy expenditure, body weight, fat mass, caloric intake, glucose tolerance, and levels of BAT and IWAT thermogenic and lipolytic proteins, plasma lipids, and markers of fatty acid oxidation in the liver in mice with APOA4 or saline treatment were measured. Plasma APOA4 levels were elevated, BAT temperature and thermogenesis were upregulated, and plasma triglyceride (TG) levels were reduced, while body weight, fat mass, caloric intake, energy expenditure, and plasma cholesterol and leptin levels were comparable between APOA4- and saline-treated mice. Additionally, APOA4 infusion stimulated sympathetic activity in BAT and liver but not in IWAT. APOA4-treated mice had greater fatty acid oxidation but less TG content in the liver than saline-treated mice had. Plasma insulin in APOA4-treated mice was lower than that in saline-treated mice after a glucose challenge. In conclusion, continuous infusion of mouse APOA4 protein stimulated sympathetic activity in BAT and the liver, elevated BAT thermogenesis and hepatic fatty acid oxidation, and consequently attenuated levels of plasma and hepatic TG and plasma insulin without altering caloric intake, body weight gain and fat mass. [ABSTRACT FROM AUTHOR]

Little is known about the association between sleep and diet in pregnancy, despite both behaviors impacting maternal and fetal health. We aimed to perform a systematic review of the available literature on associations between sleep characteristics and dietary intake and eating behaviors during pregnancy, reporting on both maternal and fetal outcomes. We followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted our search on 27 May 2021 in the PubMed, EMBASE, and CINAHL databases. The search yielded 6785 unique articles, of which 25 met our eligibility criteria. The studies, mostly observational, published 1993–2021, include data from 168,665 participants. Studies included examinations of associations between various maternal sleep measures with a diverse set of diet-related measures, including energy or nutrient intake (N = 12), dietary patterns (N = 9), and eating behaviors (N = 11). Associations of maternal exposures with fetal/infant outcomes were also examined (N = 5). We observed considerable heterogeneity across studies precluding our ability to perform a meta-analysis or form strong conclusions; however, several studies did report significant findings. Results from this systematic review demonstrate the need for consistency in methods across studies to better understand relationships between diet and sleep characteristics during pregnancy. [ABSTRACT FROM AUTHOR]

Evidence suggests that athletes competing in team sports do not follow dietary recommendations. However, only few studies have investigated energy needs and supplement use in adolescent athletes, and whether they are meeting their energy requirements. This observational study examined energy expenditure, dietary energy intake, and use of nutritional supplements in 58 adolescent (14–17 years old) volleyball athletes (15 males, 43 females) and 58 age-matched nonathletic controls (13 males, 45 females). Participants completed an online survey including questions on demographic information, body mass, and a series of standardized questionnaires assessing energy expenditure, dietary energy, macronutrient, micronutrient, and supplement intake. Energy expenditure relative to body mass was higher in athletes than nonathletes by 13 kcal/kg/day (group effect, p < 0.001), and in males compared to females by 5.7 kcal/kg/day (sex effect, p = 0.004). Athletes had higher energy intake than nonathletes (+6.4 kcal/kg/day, p = 0.019) and greater consumption of fruits (p = 0.034), vegetables (p = 0.047), grains (p = 0.016), dairy (p = 0.038), meats and meat alternatives (p < 0.001), as well as higher intakes of fat (p < 0.001), carbohydrates, protein, sugar, fiber, vitamin C, calcium, and sodium (p = 0.05) compared to nonathletes. The average protein intakes exceeded the upper recommendations in all groups, suggesting that this is not a nutrient of concern for young volleyball athletes. However, athletes were only meeting 60% of the estimated energy requirements (EER) for their age, height, body mass, and physical activity score, (3322 ± 520 kcal/day), while nonathletes were meeting 74% of the EER (p < 0.001). The relative energy balance of male athletes was lower compared to both female athletes (p = 0.006) and male nonathletes (p = 0.004). Finally, more athletes reported using performance-related supplements than nonathletes, but there were no differences in the consumption of other dietary supplements. Overall, when compared to nonathletic controls, both male and female adolescent volleyball athletes were found to match their higher energy expenditure with a greater dietary energy intake; however, all adolescents were below the estimated energy requirements, a finding more profound among the volleyball athletes. [ABSTRACT FROM AUTHOR]

Abstract Background It is common that inadequate nutritional intake happens in patients with congenital heart disease (CHD), which can adversely affect the prognosis of patients. However, the details and reasons are not clear enough so far. Therefore, the primary aim of this study was to investigate the current nutritional requirements and energy intake on days 1–7 in the cardiac intensive care unit after surgery. Our secondary aim was to investigate potential factors that hinder nutritional supply and to compare the resting energy expenditure (REE) based on two methods, the Fick method and the Schofield equation. Methods Using retrospective analysis, we collected data from postoperative children with CHD at a children's hospital in Shanghai, China. We used the Fick method to calculate the REE, and compare the results with the actual enteral nutrition intake. Meanwhile, we recorded the initiation time of enteral nutrition, feeding intolerance, unfinished milk volume, etc. Then the correlation between the results of the Fick method and the equation method was calculated. Results A total of 49 patients were included, with a median age of 22 months (IQR 4.9, 57.3), and a median Aristotle basic complexity score of 8 (IQR 6.0, 9.8). The time interval for surgical intervention within 7 days after operation was 4 (IQR 2.5, 6). No statistical difference in REE on postoperative days 1–7. The average enteral nutrition energy provided 64.6 (33.6, 79.6)% of the REE, which showed a significant decrease on postoperative day 4, and then reached its lowest on postoperative day 5. The protein supply was 0.7 ± 0.3 kcal/kg/d. In addition, the REE calculated by the Fick method was moderately correlated with that estimated by the equation (r = 0.467, P = 0.001). Conclusions The energy and protein supply in the acute postoperative period in children with CHD is inadequate. Fluid restriction and fasting may be the main causes. In addition, there is a moderate correlation between the REE calculated by the Fick method and that estimated by the equation.

Several meta-analyses have found a positive association between a popular type of “fad diet”, ketogenic diets, and their effect on anthropometric and blood parameters. However, the non-specific inclusion criteria for meta-analyses may lead to incorrect conclusions. The aim of this literature review is to highlight the main confounders and methodological pitfalls of meta-analyses on ketogenic diets by inspecting the presence of key inclusion criteria. The PubMed, Embase, and Web of Science databases and the Cochrane Database of Systematic Reviews were searched for meta-analyses. Most meta-analyses did not define the essential parameters of a ketogenic diet (i.e., calories, macronutrient ratio, types of fatty acids, ketone bodies, etc.) as inclusion criteria. Of the 28 included meta-analyses, few addressed collecting real, re-measured nutritional data from the ketogenic diet and control groups in parallel with the pre-designed nutritional data. Most meta-analyses reported positive results in favor of ketogenic diets, which can result in erroneous conclusions considering the numerous methodological pitfalls and confounders. Well-designed clinical trials with comparable results and their meta-analyses are needed. Until then, medical professionals should not recommend ketogenic diets as a form of weight loss when other well-known dietary options have been shown to be healthy and effective.

Dietary lipids induce apolipoprotein A4 (APOA4) production and brown adipose tissue (BAT) thermogenesis. Administration of exogenous APOA4 elevates BAT thermogenesis in chow-fed mice, but not high-fat diet (HFD)-fed mice. Chronic feeding of HFD attenuates plasma APOA4 production and BAT thermogenesis in wildtype (WT) mice. In light of these observations, we sought to determine whether steady production of APOA4 could keep BAT thermogenesis elevated, even in the presence of HFD consumption, with an aim toward eventual reduction of body weight, fat mass and plasma lipid levels. Transgenic mice with overexpression of mouse APOA4 in the small intestine (APOA4-Tg mice) produce greater plasma APOA4 than their WT controls, even when fed an atherogenic diet. Thus, we used these mice to investigate the correlation of levels of APOA4 and BAT thermogenesis during HFD consumption. The hypothesis of this study was that overexpression of mouse APOA4 in the small intestine and increased plasma APOA4 production would increase BAT thermogenesis and consequently reduce fat mass and plasma lipids of HFD-fed obese mice. To test this hypothesis, BAT thermogenic proteins, body weight, fat mass, caloric intake, and plasma lipids in male APOA4-Tg mice and WT mice fed either a chow diet or a HFD were measured. When fed a chow diet, APOA4 levels were elevated, plasma triglyceride (TG) levels were reduced, and BAT levels of UCP1 trended upward, while body weight, fat mass, caloric intake, and plasma lipids were comparable between APOA4-Tg and WT mice. After a four-week feeding of HFD, APOA4-Tg mice maintained elevated plasma APOA4 and reduced plasma TG, but UCP1 levels in BAT were significantly elevated in comparison to WT controls; body weight, fat mass and caloric intake were still comparable. After 10-week consumption of HFD, however, while APOA4-Tg mice still exhibited increased plasma APOA4, UCP1 levels and reduced TG levels, a reduction in body weight, fat mass and levels of plasma lipids and leptin were finally observed in comparison to their WT controls and independent of caloric intake. Additionally, APOA4-Tg mice exhibited increased energy expenditure at several time points when measured during the 10-week HFD feeding. Thus, overexpression of APOA4 in the small intestine and maintenance of elevated levels of plasma APOA4 appear to correlate with elevation of UCP1-dependent BAT thermogenesis and subsequent protection against HFD-induced obesity in mice. [ABSTRACT FROM AUTHOR]

The relationship between protein and energy and their appropriate proportions in hyperphenylalaninemia (HPA) or phenylketonuria (PKU) patients in terms of growth have been poorly studied, especially in those diagnosed late. We aimed to describe the protein energy ratio (P:E) and its association with body mass index (BMI) in 638 dietetic and anthropometric assessments from 54 early- or late-diagnosed HPA/PKU patients. Dietetic and anthropometric data were analyzed and classified according to BMI Z-Score and type of diagnosis, early by newborn screening (NBS) or late. Correlation between BMI Z-Score and P:E ratio was established. Percent of dietary protein from Phe-free metabolic formula was analyzed. According to the BMI Z-Score, the majority of assessments were eutrophic (69.4%). The median P:E ratio was >4 in most of the overweight assessments. Remarkably, the underweight group consumed the highest proportion of Phe-free metabolic formula (74.5%). A positive correlation between BMI Z-Score and P:E ratio was found. The highest proportion of underweight was found in the late-diagnosed patients. Our findings might be related to their nutritional history previous to the HPA/PKU treatment. Thus, complex nutritional outcome of the late-diagnosed HPA/PKU patients deserves actions to guarantee the early diagnosis, closer nutritional follow-up and alternative therapeutic approaches. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper looks at changes in weight, physical activity, and food/dietary intake during the first year of the COVID-19 pandemic in undergraduate students enrolled in a Canadian university. The investigation used an online survey format to collect data at the end of the two lockdown periods over one year. Participants were recruited from universities across Canada. The results show a modest weight gain accompanied by a decrease in physical activity and an unhealthy change in diet. Specifically, students reported that their engagement in specific physical activities and overall activity levels decreased during the lockdowns. The number of calories also decreased over time, while the foods consumed decreased in nutritional value. Thus, the modest weight gain observed may have resulted from the decrease in physical activity and diet quality. In conclusion, Canadian food and physical activity recommendations were not met during the lockdowns caused by the pandemic, which highlights the physical and nutritional implications of confinement. This study examined changes in body mass and body mass index (BMI), physical activity, and dietary intake in Canadian university students during the first year of the COVID-19 pandemic. Two self-reported recall surveys were conducted: after the first lockdown in September 2020 (T1) and following the second lockdown in March 2021 (T2). Eligible participants were full-time undergraduate students attending a Canadian university and residing in Canada during the first year of the pandemic. At T1, 510 students (99 male, 411 female) completed the survey, and of those, 135 (32 males, 103 females) completed the survey at T2 (73% attrition). At both T1 and T2, most participants were 18–24 years of age (93% and 90%, respectively), Caucasian (73% and 78%, respectively), and resided in the province of Ontario (79% and 80%, respectively). Body mass increased from T1 to T2 (+0.91 ± 3.89 kg t(132) = −2.7, p = 0.008). BMI also increased from T1 to T2 (+0.30 ± 1.33 kg/m2 [t(130) = −2.5, p = 0.012), with a greater number of participants within the overweight range (19.8% versus 24.4%, respectively). At T1, 38% of the participants reported a decrease in physical activity, while the number of students reporting a decrease in activity increased to 56% at T2. Dietary energy intake decreased from 1678 ± 958 kcal/day at T1 to 1565 ± 842 kcal/day at T2 [c2(1) = 7.2, p = 0.007]. Diet quality also decreased, with participants not meeting the recommended daily allowance for essential macro and micronutrients. A decrease was observed in daily servings of fruits (−27%, p < 0.001), vegetables (−72%, p < 0.001), and grains (−68%, p < 0.001). In conclusion, despite a small decrease in dietary energy intake, a modest weight gain occurred during the first year of the COVID-19 pandemic in this cohort of Canadian university students, which was potentially related to decreased physical activity and diet quality. [ABSTRACT FROM AUTHOR]

Simple Summary: Dogs with cancer often lose their appetite, which leads to weight loss and affects their general health. This study investigated the acceptance of a new therapeutic, nutritionally balanced and calorically dense food by dogs with cancer. The results showed that the dogs readily ate the food, which led to improved caloric intake, increased body weight, and maintained high quality of life. Diminished appetite and poor eating behavior accompanied by weight loss or cachexia are often reported in dogs living with cancer. This study was conducted to determine the acceptance and eating enthusiasm in dogs with cancer for a new therapeutic, nutritionally balanced, and calorically dense food designed for dogs with cancer. Adult dogs with diagnosis of cancer were recruited from general and oncology practices and were fed the study food for 28 days. Evaluations included physical examination, body weight, food intake, caloric intake, hematology and serum biochemistry, and owner assessments, namely food evaluation, quality of life, and stool scores. The dogs transitioned smoothly and tolerated the food very well. The results showed high food acceptance within the first day, with continued eating enthusiasm over the 28 days. Significant increases in food and caloric intake were observed, with the study food having a positive impact on body weight in dogs that were losing weight and helping to maintain a high quality of life. Blood laboratory parameters remained within reference ranges. Thus, the therapeutic study food was well accepted and efficacious in supporting continued eating and required caloric intake, promoting a healthy weight gain and maintaining a high quality of life in dogs with cancer. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the role of diet quality in children with tympanostomy tube placement (TTP) complicated by tympanostomy tube otorrhea (TTO)., Study Design: Three-day 24-hour diet recall., Setting: Tertiary care medical center., Methods: Children between the ages of 2 to 6 years old with TTP performed 6 months to 2 years prior to enrollment were included. Children with a history of Down syndrome, cleft palate, craniofacial syndromes, known immunodeficiency, g-tube dependent, or a non-English speaking family were excluded. The primary outcome variable was TTO. The primary predictor was total caloric intake measured by percent estimated energy rate (%EER)., Results: A total of 120 families completed the 3-day diet recall. The median age was 27 months (interquartile range: 7.9-68.5), with 57% male sex. Most children reported dietary intake within the recommended range percent intake for carbohydrates and fat and less than recommended range for percent vitamin D. Within this cohort 63 (52.5%) participants had >1 TTO episode and 57 (47.5%) ≤ 1 TTO episode. Children with an EER% that was average or high were at higher odds of >1 TTO episodes compared to participants with a low EER% with ORs of 4.6 (95% confidence interval [CI]: 1.4, 15.6) and 5.7 (95% CI: 1.5, 22.1) respectively., Conclusion: Children with a typical or high total daily caloric intake are approximately 5 to 6 times more likely to have multiple TTO episodes compared to those with low intake., (© 2024 The Author(s). Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Late-day eating is linked to increased obesity risk; however, whether the endogenous circadian system independently influences caloric intake and if this control differs among individuals based on weight status is unknown. Here, we investigated in adolescents the independent roles of the endogenous circadian system and of the behavioral sleep/wake cycle (sleep/wake, fasting/eating, rest/activity, dark/dim light, social interaction, posture, etc.) on self-selected caloric intake using a Forced Desynchrony protocol. Fifty-one male and female adolescents across three weight status categories (24 with healthy weight, 13 with overweight, and 14 with obesity) completed the protocol where participants lived on seven 28-h sleep/wake cycles in dim light during wake and complete darkness during sleep. Results suggest that the circadian system and the behavioral cycle each affected caloric intake, with a decrease across the wake episode and an increase from circadian morning to circadian evening in caloric intake. The endogenous circadian rhythm in caloric intake showed a circadian peak-to-trough difference of 196 [CI 95% 164, 226] kcal per meal with peak timing of 296° [288°, 304°; equivalent to ~17:30 in these participants]. In those with overweight/obesity, more calories were consumed later in the waking episode and later in the circadian cycle, and with blunted amplitudes compared to those with healthy weight. Results implicate both the endogenous circadian system and the behavioral cycle in shaping the daily rhythm of food intake. Furthermore, these results help explain the increased drive for caloric intake toward the evening, especially in those at risk for obesity., Competing Interests: Competing interests statement:F.A.J.L.S. served on the Board of Directors for the Sleep Research Society and has received consulting fees from the University of Alabama at Birmingham and Morehouse School of Medicine. F.A.J.L.S. interests were reviewed and managed by Brigham and Women’s Hospital and Partners HealthCare in accordance with their conflict-of-interest policies. F.A.J.L.S. consultancies are not related to the current work. C.N.H. has received consulting fees from the University of South Carolina and serves as a consultant on a grant funded by the Novo Nordisk Foundation. C.N.H. interests were reviewed and managed by Temple University in accordance with their conflict-of-interest policies. These consultancies are unrelated to the current work. None of the other authors have competing interests to the work presented in this manuscript.

Background: Meal variety promotes overconsumption by delaying sensory-specific-satiety (SSS), the transient reduction in reward value of a recently consumed food. Despite its role in meal cessation, the neuroendocrine mechanisms underlying SSS are largely unknown., Methods: Here, we developed a preclinical model of SSS wherein rats consume more of a different food compared to the same food presented again, leading to greater caloric intake. Using pharmacological and molecular approaches targeting the brainstem, we investigated the involvement of the satiation signal, glucagon-like peptide-1 (GLP-1), in mediating SSS in male rats (n=96) and in female rats (n=85) across their estrous cycle. We also evaluated the sufficiency of the hormone estradiol to modulate GLP-1 and SSS., Results: In males, brainstem GLP-1 receptors (GLP-1Rs) were necessary for the SSS-induced decrease in same food intake, while agonizing brainstem GLP-1Rs was sufficient to attenuate overconsumption of the different food. Female rats showed SSS in an estrous cycle-dependent manner and did not consume more of the different food in diestrus-to-Proestrus and proestrus-to-Estrus. However, blockade of brainstem GLP-1R restored different food overconsumption. Furthermore, the brainstem's nucleus tractus solitarius and area postrema showed increased expression of the GLP-1 precursor, glucagon (Gcg), during diestrus-to-Proestrus and proestrus-to-Estrus, and greater Glp1r expression in proestrus-to-Estrus. Similarly, 17β-estradiol injections in males not only increased Glp1r and Gcg expression, but also reduced SSS., Conclusion: We identified a bidirectional role for brainstem GLP-1R signaling in modulating SSS; effects that are estrous cycle-dependent. Moreover, our data indicate that estradiol regulates Glp1r and Gcg expression and likely influences SSS., (Copyright © 2025. Published by Elsevier Inc.)

Abstract Background Despite the known benefits of non-sedentary behavior, physical activity, and protein and caloric intake to health and muscle mass, strength, and function, many older adults do not meet physical activity and dietary recommendations. A better understanding of the factors associated with sedentary behavior, physical activity and dietary self-management behaviors, and muscle outcomes (muscle mass, strength, and function) is needed, particularly among continuing care retirement community residents. The objective of this study was to examine the factors associated with sedentary behavior, physical activity and dietary self-management behaviors, and muscle outcomes among continuing care retirement community residents. It also aimed to determine whether sedentary behavior and physical activity and dietary self-management behaviors mediate the relationships between self-efficacy, goal congruence, aging expectations, social support, and muscle outcomes. Methods A sample of 105 continuing care retirement community residents (age > 70 years) participated in this correlational, cross-sectional study. Questionnaires on pain, self-efficacy, goal congruence, aging expectation, social support, and daily protein and caloric intake were administered. Physical activity and sedentary behavior (ActiGraph wGT3X-BT), muscle mass (ImpediMed SFB7), muscle strength (Jamar Smart Digital Hand Dynamometer), and muscle function (Short Physical Performance Battery) were measured. Multiple regression, logistic regression, and mediation analyses were performed. Results Low goal congruence predicted engagement in sedentary behavior and light physical activity. Higher levels of self-efficacy and social support were associated with increased likelihoods of achieving greater moderate physical activity and meeting daily recommendations for caloric intake, respectively. Self-efficacy and goal congruence predicted muscle function and strength. Moreover, sedentary behavior and achieving greater moderate physical activity were found to partially but significantly mediate the relationship between self-efficacy and muscle function. Conclusion Future research should evaluate whether attempts to reduce sedentary behavior and promote physical activity and dietary self-management behaviors and muscle outcomes are more successful when modifications to the self-management process factors are also targeted.

Few studies have investigated which types of food are least reported among underreporters of energy intake (EI). This study assessed the association between the underreporting of EI and the consumption report of food groups according to NOVA classification in women in social vulnerability. EI was measured through three 24‐h dietary recalls administered by the research team. Total energy expenditure (TEE) was evaluated using the doubly labelled water method. The percentage of EI arising from each NOVA group food classification (unprocessed/minimally processed foods, culinary ingredients, processed foods and ultra‐processed foods [UPF]) was calculated. The agreement between the EI and the TEE was assessed using the ratio EI:TEE. Associations were assessed with Pearson's correlation and multivariable linear regression, adjusted for age, education and body fat. The sample (63 women, age: 30.8 years, Body Mass Index: 27.6 kg/m2) reported an EI of 1849 kcal and a TEE of 2223 kcal, with a mean EI:TEE of 0.85. There were no significant correlations between the EI:TEE and the reported food intake according to NOVA classifications. Multivariable linear regression also did not show any significant associations (UPF: 8.47, 95% CI: [−3.65; 20.60] %kcal; Processed: −6.85, [−19.21; 7.71] %kcal; Culinary ingredients: 1.30 [−5.10; 7.71] %kcal; Unprocessed/minimally processed: −2.92 [−10.98; 5.13] %kcal). In conclusion, socially vulnerable women that underreport their EI do not report a lower intake of any specific group of foods according to NOVA classification. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to calculate the basal metabolic rate (BMR) with the Mifflin equation based on the expected body mass for normal body mass index (BMI) values in obese patients treated in spa conditions. Methods: Patients with morbid obesity (BMI > 40 kg m–2) and non‐obese controls (BMI < 30 kg m–2) were recruited. In total, 104 patients with morbid obesity (mean BMI ± standard deviation, 46.9 ± 2.1 kg m–2) treated in spa conditions and 90 non‐obese controls (mean BMI, 28 ± 1.3 kg m–2) were included in the present study. Results: The mean BMR calculated based on actual body mass was 2088 ± 303 kcal in patients with morbid obesity and 1424 ± 268 kcal in non‐obese controls. The BMR calculated based on expected body mass for normal BMI decreased significantly in patients with morbid obesity (p < 0.01), but not in non‐obese controls. Accordingly, energy expenditure and planned caloric intake was significantly lower when BMR was calculated based on expected body mass rather than actual body mass in patients with morbid obesity, but not in non‐obese controls (p < 0.01). Conclusions: Expected body mass for normal BMI should be used to calculate the BMR in patients with morbid obesity. Key points: Dietary treatment should be set individually for each patient.A combination of balneological procedures with a low energy diet achieves the best possible results for the conservative treatment of obesity.In the present study, using body mass for basal metabolic rate (BMR) calculation helped with the planning of a low‐calorie diet.The results showed that, when actual body mass was used to calculate the BMR with the Mifflin equation, the average daily caloric requirement was 2715 kcal. [ABSTRACT FROM AUTHOR]

Abstract Background The duration and frequency of eating occasions has been identified as a factor contributing to poor dietary quality among U.S. adults. The objective of this study is to examine whether grazing, defined as eating more than three times a day, affects total daily caloric intake and dietary quality measured by the 2015 Healthy Eating Index (HEI-2015). Methods We used a multivariate individual fixed-effects model to compare the caloric intake and dietary quality of individuals who grazed on 1 day but not another. This allowed us to control for differences in individual food intake and diet quality preferences among study participants. We use the National Health and Nutrition Examination Survey (NHANES), 2007-2018, and include data for adults aged 18 years or older who reported 2 days of dietary intake and were not pregnant or lactating (n = 27,775). Results Grazing increased total daily caloric intake by 205 cal and increased the daily HEI score by 0.59 points. Grazing increased HEI component scores for total fruit, whole fruit, and refined grains, and decreased HEI component scores for saturated fats. Morning grazing increased total daily caloric intake by 159 cal and increased the daily HEI score by 0.87 points — primarily by increasing component scores for total fruit, whole fruit, whole grains, total dairy, seafood and plant proteins, and sodium. Evening grazing increased daily caloric intake by 76 cal and decreased the daily HEI score by 0.41 points — primarily by decreasing the component scores for total fruit, whole grains, fatty acids, and saturated fats. Evening grazing increased HEI component scores for sodium and refined grains. Conclusions Grazing increases daily caloric intake and can decrease dietary quality (particularly when grazing in the evening).

Obesity is associated with alterations in cholesterol and bile acid (BA) metabolism. However, the interaction among dietary intake, cholesterol absorption, and BA metabolism in patients with obesity remains unclear. We conducted a 4-wk nutritional intervention nonrandomized clinical trial with three different sequential diets for a week in the following order: regular diet (RD); high calorie, high-fat diet (HCHF), washout period on RD; and low-calorie, low-fat diet (LCLF). We provided participants with meal replacements during HCHF and LCLF diets. A total of 16 participants completed the study [n = 8 normal weight (NW); n = 8 with obesity (OB)]. Overall, there was a significant increase in intestinal cholesterol uptake when changing from RD to HCHF and a reduction in intestinal cholesterol uptake from HCHF to LCLF. When analyzing by BMI groups, these findings were similar in patients with NW (RD to HCHF: P < 0.007; HCHF to LCLF: P = 0.02); however, in patients with obesity, the change in intestinal cholesterol uptake was only observed when changing from RD to HCHF (P = 0.006). There was no correlation between cholesterol absorption and fecal bile acids or other markers of BA metabolism in all patients or the subgroups. Dietary caloric content had a significant effect on cholesterol absorption, however, this effect is blunted in patients with obesity. These data are consistent with the impaired effect of a low-fat diet on cholesterol absorption in obesity. [ABSTRACT FROM AUTHOR]

Background: It is common that inadequate nutritional intake happens in patients with congenital heart disease (CHD), which can adversely affect the prognosis of patients. However, the details and reasons are not clear enough so far. Therefore, the primary aim of this study was to investigate the current nutritional requirements and energy intake on days 1-7 in the cardiac intensive care unit after surgery. Our secondary aim was to investigate potential factors that hinder nutritional supply and to compare the resting energy expenditure (REE) based on two methods, the Fick method and the Schofield equation.Methods: Using retrospective analysis, we collected data from postoperative children with CHD at a children's hospital in Shanghai, China. We used the Fick method to calculate the REE, and compare the results with the actual enteral nutrition intake. Meanwhile, we recorded the initiation time of enteral nutrition, feeding intolerance, unfinished milk volume, etc. Then the correlation between the results of the Fick method and the equation method was calculated.Results: A total of 49 patients were included, with a median age of 22 months (IQR 4.9, 57.3), and a median Aristotle basic complexity score of 8 (IQR 6.0, 9.8). The time interval for surgical intervention within 7 days after operation was 4 (IQR 2.5, 6). No statistical difference in REE on postoperative days 1-7. The average enteral nutrition energy provided 64.6 (33.6, 79.6)% of the REE, which showed a significant decrease on postoperative day 4, and then reached its lowest on postoperative day 5. The protein supply was 0.7 ± 0.3 kcal/kg/d. In addition, the REE calculated by the Fick method was moderately correlated with that estimated by the equation (r = 0.467, P = 0.001).Conclusions: The energy and protein supply in the acute postoperative period in children with CHD is inadequate. Fluid restriction and fasting may be the main causes. In addition, there is a moderate correlation between the REE calculated by the Fick method and that estimated by the equation. [ABSTRACT FROM AUTHOR]

Estimates of prey and energy consumption are important for effective management and conservation of marine mammals and the ecosystems they inhabit. We used routinely collected husbandry data on body mass, food intake (kilograms), and energy intake (megajoules) from northern fur seals (Callorhinus ursinus) in zoological institutions to examine how these variables changed throughout the year, and with age, sex, and reproduction. Fur seals exhibited seasonal changes in all three variables, but the magnitude and timing of trends varied among age and sex groups. Notably, adult males exhibited rapid increases in body mass leading up to the breeding season. Fur seals were most efficient at converting energy intake to mass gain in the spring and least efficient in the fall. Intake increased into adulthood as animals grew in body mass. Sex‐specific differences in intake were detectable early in development, likely related to size dimorphism. Pregnancy was energetically inexpensive compared with lactation, with food and energy intake rapidly increasing post parturition to values that were double those during early pregnancy. This study highlights the importance of accounting for different age, sex, and life history stages when estimating prey consumption of northern fur seals. [ABSTRACT FROM AUTHOR]

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There is convincing scientific evidence that the use of oral nutritional supplements (ONS) is advantageous in patients with disabling neurologic diseases such as stroke, dementia, amyotrophic lateral sclerosis, multiple sclerosis or Parkinson’s disease, and also in older patients with a diagnosis of malnutrition or just risk of malnutrition, and in all these cases accompanied with insufficient oral food intake or during a condition such as infection, trauma or hospitalization that may pose an increased malnutrition risk along. A wide spectrum of commercial formulas ensuring adequate patient adaptation and toleration are available. For ONS supply to be beneficial, a person at risk of malnutrition or with the diagnosis of malnutrition should consume ONS containing at least 400 kcal of energy and 30 grams of protein per day for a minimum of 1 month. ONS should not reduce the amount of normal daily food intake. If useful, ONS should be continued within the scope of predetermined goals. Supplementation of ONS is an economical and useful neurology practice.

Snacking of small quantities of palatable food items throughout the day is common in modern societies and is promoted by 24/7 lifestyles. Long-term mistimed high-caloric food intake disrupts endogenous circadian rhythms and supports the development of obesity and other metabolic disorders. However, less is known about the time-of-day dependent effects of snacking. We hypothesized that already a single snacking episode may affect the circadian regulation of metabolic parameters, in particular when the snack is consumed during the daily rest phase. We performed an acute snack experiment in mice by providing access to chow or chocolate either at day- or nighttime and assessed snack effects on core body temperature, locomotor activity, and gene expression in metabolic tissues. Our results show that daytime chocolate snacking leads to a higher body temperature and locomotor activity increase compared to chow and nighttime intake. This goes along with altered clock and metabolic gene expression in peripheral tissues. Changes in nutrient uptake transporter gene expression in the small intestine suggest increased glucose resorption after daytime snacking. Our results indicate an early mechanism for the adipogenic effect of mistimed high-calorie snacking.

Objective: The study aim was to elucidate the degree to which hyper‐palatable foods (HPF) are consumed during binge episodes compared to restricting episodes, and to test the association between HPF intake during each episode and respective episode frequency. Method: This study was a secondary analysis of data from a larger study on eating disorders. The present sample included adults (N = 147, 83% women) diagnosed with sub‐threshold (41%) or full‐threshold (59%) bulimia nervosa (BN). Foods consumed during binge and restricting episodes were assessed using the Eating Pathology Symptoms Inventory–Clinician Rated Version. A standardized definition of HPF developed previously was applied to foods consumed during binge and restricting episodes. A Wilcoxon matched‐pairs signed‐rank test was used to test the difference between total caloric intake from HPF (KcalHPF) and percentage of caloric intake from HPF (PercHPF) during binge episodes relative to restricting episodes. Four linear regression models tested HPF intake (KcalHPF and PercHPF) during both episode types (binge and restricting) as predictors of respective episode frequency. Results: There was a significant difference between median KcalHPF (1846.6 vs. 279.6; Z = −13.38, p <.001) and PercHPF during binge compared to restricting episodes (95% vs. 61%; Z = −7.35, p <.001). Regression analyses demonstrated that KcalHPF during binge episodes was significantly associated with binge episode frequency (B = 0.002; p <.001), but not PercHPF (p =.287). Discussion: Results suggest that HPF may be primarily consumed during binge episodes among individuals with BN, and may be associated with greater binge‐eating frequency. Public Significance: Findings from the current study support an underlying assumption of theoretical models of binge eating, suggesting that highly rewarding, hyper‐palatable foods (HPF), may constitute the vast majority of energy intake during binge‐eating episodes. Additionally, a substantial amount of energy intake from HPF may occur during restricting episodes among people with bulimia nervosa. Greater HPF intake during binge eating may also be associated with binge‐eating severity. [ABSTRACT FROM AUTHOR]

Policaptil Gel Retard® (PGR), a natural fiber-based molecule, has been shown to prevent weight gain and ameliorate insulin-resistance indices in obese children and adolescents. The aim of this study was to compare the effects of 12 weeks of low calories and low glycemic index (LC-LGI) diet associated or not with the intake of PGR on anthropometric, bioimpedance, and metabolic parameters. Data from 20 obese adult subjects (10 per group) were analyzed. An LC-LGI diet with or without PGR intake reduced weight, BMI, and waist circumference. PGR intake elicited a reduction in fasting plasma insulin and insulin resistance index together with an improvement in insulin sensitivity [ABSTRACT FROM AUTHOR]

Our study examined the association between hedonic hunger and body mass and whether caloric intake mediated the association between these constructs in adolescents. One hundred adolescents with overweight or obesity completed measures of hedonic food reward, dietary intake, and height and weight. Exaggerated hedonic food responses were associated with higher body mass. For 16% of participants who had high hedonic hunger, and high body mass, caloric intake mediated the association between hedonic hunger and zBMI. These results suggest that hedonic hunger may override the homeostatic need for energy and may be associated with increased caloric intake, potentiating weight gain. [ABSTRACT FROM AUTHOR]

• Overweight and obesity are highly prevalent in this study population of DMD patients. • Detailed, longitudinal exploration on the BMI-z course shows an increase around the period of losing ambulation, which starts already before patients become wheelchair bound. • Cross sectionally corticosteroid use was associated with higher BMI-z scores and exceeding the recommended caloric intake was associated with higher BMI in non- ambulatory patients. • Although longitudinal mixed model analysis did not show significant association between BMI-z score and corticosteroid use or caloric intake, explorative analysis of the longitudinal data show that BMI-z increases before caloric intake is adjusted (often from the moment patients become wheelchair bound). Earlier intervention in caloric intake could probably help to prevent obesity. We aimed to investigate BMI-z course in patients with Duchenne muscular dystrophy (DMD) during transition to loss of ambulation, and to explore the contribution of caloric intake and corticosteroid use. A retrospective multicenter longitudinal study was conducted. First, analyses of characteristics at first visit were carried out. Second, discontinuous change models were fitted to explore associations between BMI-z, loss of ambulation, caloric intake and corticosteroid use. 790 visits of 159 patients were collected. Cross sectional first visit analyses showed the presence of overweight and obesity was 44% in the ambulant group and 51% in the non-ambulant group. In the non-ambulatory group, exceeding the recommended caloric intake was associated with higher BMI-z scores (r 0.36, p = 0.04). Patients who were using corticosteroids had significantly higher BMI-z scores compared with patients not using corticosteroids (1.06 and 0.51 respectively, p = 0.02). Longitudinal analyses on patients ambulant at first visit showed an increase in BMI-z score during transition to the non-ambulatory phase. Caloric intake and corticosteroid use were not associated with BMI-z. Transition to the non-ambulatory phase may be crucial in the development of excessive weight gain. Early measures – starting before this time frame – may contribute to reduce development of obesity. [ABSTRACT FROM AUTHOR]

Background: Despite the known benefits of non-sedentary behavior, physical activity, and protein and caloric intake to health and muscle mass, strength, and function, many older adults do not meet physical activity and dietary recommendations. A better understanding of the factors associated with sedentary behavior, physical activity and dietary self-management behaviors, and muscle outcomes (muscle mass, strength, and function) is needed, particularly among continuing care retirement community residents. The objective of this study was to examine the factors associated with sedentary behavior, physical activity and dietary self-management behaviors, and muscle outcomes among continuing care retirement community residents. It also aimed to determine whether sedentary behavior and physical activity and dietary self-management behaviors mediate the relationships between self-efficacy, goal congruence, aging expectations, social support, and muscle outcomes.Methods: A sample of 105 continuing care retirement community residents (age > 70 years) participated in this correlational, cross-sectional study. Questionnaires on pain, self-efficacy, goal congruence, aging expectation, social support, and daily protein and caloric intake were administered. Physical activity and sedentary behavior (ActiGraph wGT3X-BT), muscle mass (ImpediMed SFB7), muscle strength (Jamar Smart Digital Hand Dynamometer), and muscle function (Short Physical Performance Battery) were measured. Multiple regression, logistic regression, and mediation analyses were performed.Results: Low goal congruence predicted engagement in sedentary behavior and light physical activity. Higher levels of self-efficacy and social support were associated with increased likelihoods of achieving greater moderate physical activity and meeting daily recommendations for caloric intake, respectively. Self-efficacy and goal congruence predicted muscle function and strength. Moreover, sedentary behavior and achieving greater moderate physical activity were found to partially but significantly mediate the relationship between self-efficacy and muscle function.Conclusion: Future research should evaluate whether attempts to reduce sedentary behavior and promote physical activity and dietary self-management behaviors and muscle outcomes are more successful when modifications to the self-management process factors are also targeted. [ABSTRACT FROM AUTHOR]